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Title: Withdrawal of active treatment after intracerebral haemorrhage in the INTERACT2 study
Authors: Muñoz Venturelli, Paula
Wang, Xia
Zahuranec, Darin B.
Lavados, Pablo M.
Stapf, Christian
Lindley, Richard
Delcourt, Candice
Chalmers, John
Anderson, Craig S.
Robinson, Thompson G.
Robinson, Thompson G.
INTERACT2 Investigators
First Published: 9-Nov-2016
Publisher: Oxford University Press for British Geriatrics Society
Citation: Age and Ageing, 2017, 46 (2), pp. 329-332
Abstract: Background: in the second Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2), a minority of patients received withdrawal of active treatment (WAT). We wished to determine the characteristics of these patients, and the relation of this decision-making to subsequent management and final outcome. Methods: the INTERACT2 cohort of acute intracerebral haemorrhage (ICH) patients had a decision of WAT within 7 days after hospital admission recorded. Multivariable logistic regression was used to identify the determinants of WAT and poor outcome at 90 days, defined by modified Rankin scale (mRS) scores 3-6. Results: of 2,779 participants with available data, WAT occurred in 121 (4%) and this was significantly associated with increasing age, greater neurological severity, larger haematoma volume, intraventricular extension and randomisation to intensive BP lowering. Compared to other patients, those with WAT had greater mortality (81/121 [67%] versus 205/2624 [8%]; P < 0.001) and survivors were more likely to be severely disabled (mRS score 4-5, 19/39 [49%] versus 695/2419 [29%]; P = 0.006). Conclusions: WAT was undertaken in patients with recognised predictors of poor prognosis, who subsequently were more likely to die or be left with severe disability. Improved understanding of specific factors determining WAT in ICH patients might improve care delivery and outcomes. Clinical Trial Registration: the INTERACT2 study is registered with (NCT00716079).
DOI Link: 10.1093/ageing/afw187
ISSN: 0002-0729
eISSN: 1468-2834
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2016, The Author. Deposited with reference to the publisher’s open access archiving policy.
Appears in Collections:Published Articles, Dept. of Cardiovascular Sciences

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